Comparison of Injection and Home Physical Exercise with Physical Therapy in Elderly Patients with Temporomandibular Joint Degenerative Disease: A Prospective Cohort Study

Abstract Background There are few reports on the treatment of elderly patients with temporomandibular joint degenerative disease (DJD) and on the effects of physical exercise in DJD. Herein, we aimed to study and compare the efficacy of injection and home physical exercise with physical therapy alone and to explore an optimal treatment strategy for elderly patients with DJD. Methods We included 213 elderly patients with DJD treated at our medical center from June 2020 to June 2021, 64 of whom were selected for analysis. Of these 64 patients, 32 received injection combined with home physical exercise, and the other 32 received physical therapy alone. Propensity score matching was used to ensure that there were no statistically significant differences between the two groups with regard to both categorical and continuous variables. Measurements included pain intensity, maximum mouth opening, joint crepitus, jaw functional limitation scale (JFLS) scores, treatment times, and treatment durations. Improvement in each measurement was compared between the two groups at 2, 4, and 12 weeks after the start of treatment, as were the final treatment times and treatment durations. Results Pain intensity, maximum mouth opening, and JFLS scores in the two groups were improved at 2, 4, and 12 weeks after treatment (all p < 0.05). The crepitus ratio was significantly improved only in the combined treatment group at 12 weeks. Compared with the physical therapy group, improvement in mouth opening pain was improved at 2, 4, and 12 weeks in the combined treatment group; the improvement in maximal mouth opening in the physical therapy group was better than that in the injection group at 2 weeks after treatment. There were no statistically significant differences between the two groups in terms of improvement in joint crepitus and JFLS scores at each observation point. The number of visits in the combined therapy group was statistically significantly lower than that in the physical therapy group, but the treatment duration was longer. Conclusion The combined therapy showed a stronger effect on elderly patients with DJD than physical therapy alone, specifically with regard to mouth opening pain control and the number of visits.